BACKGROUND: The 'fit note', with the opportunity for the GP to advise that a patient 'may be fit' to do some work, was introduced in April 2010. AIM: To estimate numbers of fit notes with 'may be fit' advice, the types of advice, and factors associated with any inclusion of such advice in the fit note. DESIGN AND SETTING: Cross-sectional analysis of fit note data from 68 general practices in eight regions of England, Wales and Scotland. METHOD: Collection of practice fit note data via GP use of carbonised pads of fit notes for a period of 12 months. RESULTS: The 'may be fit' box was ticked on 5080 fit notes (6.4% of all fit notes in study). But there was a wide variation in completion rates across the 68 practices (from 1% to 15%). The most prevalent individual item of advice was to 'amend duties' of patient as a prerequisite for return to work (included in 42% of all notes containing any 'may be fit' advice). Advice was often incomplete or irrelevant, with some GPs failing to comply with official guidance. Inclusion of any 'may be fit' advice was independently associated with the patient being female, less socially deprived and having a physical health reason for receiving a fit note. CONCLUSION: Unlike other studies that have relied upon eliciting opinion, this study investigates how the fit note is being used in practice. Findings provide some evidence that the fit note is not yet being used to the optimum benefit of patients (and their employers).
BACKGROUND: The 'fit note', with the opportunity for the GP to advise that a patient 'may be fit' to do some work, was introduced in April 2010. AIM: To estimate numbers of fit notes with 'may be fit' advice, the types of advice, and factors associated with any inclusion of such advice in the fit note. DESIGN AND SETTING: Cross-sectional analysis of fit note data from 68 general practices in eight regions of England, Wales and Scotland. METHOD: Collection of practice fit note data via GP use of carbonised pads of fit notes for a period of 12 months. RESULTS: The 'may be fit' box was ticked on 5080 fit notes (6.4% of all fit notes in study). But there was a wide variation in completion rates across the 68 practices (from 1% to 15%). The most prevalent individual item of advice was to 'amend duties' of patient as a prerequisite for return to work (included in 42% of all notes containing any 'may be fit' advice). Advice was often incomplete or irrelevant, with some GPs failing to comply with official guidance. Inclusion of any 'may be fit' advice was independently associated with the patient being female, less socially deprived and having a physical health reason for receiving a fit note. CONCLUSION: Unlike other studies that have relied upon eliciting opinion, this study investigates how the fit note is being used in practice. Findings provide some evidence that the fit note is not yet being used to the optimum benefit of patients (and their employers).
Entities:
Keywords:
general practice; return to work; sickness certification
Authors: Johanna Kausto; Helena Miranda; Kari-Pekka Martimo; Eira Viikari-Juntura Journal: Scand J Work Environ Health Date: 2008-09-15 Impact factor: 5.024
Authors: Sarah Dorrington; Ewan Carr; C Polling; Sharon Stevelink; Mark Ashworth; Emmert Roberts; Matthew Broadbent; Stephani Hatch; Ira Madan; Matthew Hotopf Journal: BMJ Open Date: 2021-03-26 Impact factor: 2.692
Authors: Sarah Dorrington; Ewan Carr; Sharon Stevelink; Mark Ashworth; Matthew Broadbent; Ira Madan; Stephani Hatch; Matthew Hotopf Journal: BMJ Open Date: 2021-11-11 Impact factor: 2.692